MATRix/IELSG43
MATRix/IELSG43 settled how to consolidate remission in lymphoma of the brain: after MATRix chemotherapy, a high-dose chemotherapy and stem cell transplant kept 78 percent of patients free of progression at three years against 51 percent with conventional consolidation chemotherapy, and also lengthened survival, so transplant is now the preferred consolidation for fit patients.
Overview
MATRix/IELSG43 was a randomised phase 3 trial of the German and IELSG groups in 368 patients aged 18 to 70 with newly diagnosed primary CNS lymphoma. All received four cycles of MATRix (methotrexate, cytarabine, thiotepa, rituximab); 230 patients with responding or stable disease were randomised to high-dose chemotherapy (carmustine and thiotepa) with autologous stem cell transplant or to two cycles of non-myeloablative R-DeVIC. The primary endpoint was progression-free survival.
At a median follow-up of 45.3 months three-year progression-free survival was 78 percent after transplant against 51 percent after R-DeVIC (hazard ratio 0.43), and overall survival was also better. Adverse events were more frequent with transplant (14.6 against 9.3 per patient) and five patients died after transplant consolidation against two after R-DeVIC. The corpus's primary CNS lymphoma page cites IELSG43 with IELSG32 for thiotepa-based chemotherapy with autologous transplant.
- 78 vs 51 out of 100 alive without the cancer growing at 3 years with High-dose carmustine-thiotepa and autologous stem cell transplant compared with R-DeVIC non-myeloablative consolidation; 27 more per 100.
- Roughly one extra person helped for every 4 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- Put another way, the treated group had about 57 percent lower chance of the event at any given time (hazard ratio 0.43, likely range 0.27 to 0.68).
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- High-dose carmustine-thiotepa and autologous stem cell transplant: 14.6; R-DeVIC non-myeloablative consolidation: 9.3.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- High-dose carmustine-thiotepa and autologous stem cell transplant: 5 participants; R-DeVIC non-myeloablative consolidation: 2 participants.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: Newly diagnosed primary central nervous system lymphoma in patients up to 70 responding to four cycles of MATRix induction: consolidation with high-dose carmustine and thiotepa and autologous stem cell transplant against two cycles of non-myeloablative rituximab, dexamethasone, etoposide, ifosfamide and carboplatin (R-DeVIC). People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
368 registered.
95% CI 69 to 85; median follow-up 45.3 months · 95% CI 41 to 60
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 3 yearsprimary | High-dose carmustine-thiotepa and autologous stem cell transplant | 114 | 78% | 0.43 (0.27 to 0.68) | 0.0003 | link |
| R-DeVIC non-myeloablative consolidation | 115 | 51% | ||||
| Mean adverse events per patient | High-dose carmustine-thiotepa and autologous stem cell transplant | 114 | 14.6 | - | - | link |
| R-DeVIC non-myeloablative consolidation | 115 | 9.3 | ||||
| Fatal serious adverse events after consolidation | High-dose carmustine-thiotepa and autologous stem cell transplant | 114 | 5 participants | - | - | link |
| R-DeVIC non-myeloablative consolidation | 115 | 2 participants |
Similar pages
not linked directly; found by shared links- TrialIELSG32
Shares International Extranodal Lymphoma Study Group, Carmustine, Thiotepa, Cytarabine and the tag soc-trials.
- TrialACNS0122
Shares Thiotepa, Ifosfamide, Autologous stem cell transplant (high-dose therapy), Brain and spinal cord tumours (all types) and the tag soc-trials.
- TrialACNS0333
Shares Thiotepa, Autologous stem cell transplant (high-dose therapy), Methotrexate, Brain and spinal cord tumours (all types) and the tag soc-trials.
- TrialBMT CTN 0803
Shares Carmustine, Cytarabine, Autologous stem cell transplant (high-dose therapy), Etoposide and the tag soc-trials.
- TrialACNS1123
Shares Ifosfamide, Brain and spinal cord tumours (all types), Etoposide, Carboplatin and the tag soc-trials.
- TrialTRIANGLE
Shares Cytarabine, Autologous stem cell transplant (high-dose therapy), Rituximab, Non-Hodgkin lymphoma (all types) and the tag soc-trials.
- TrialACNS0121
Shares Brain and spinal cord tumours (all types), Etoposide, Carboplatin, Cytotoxic chemotherapy and the tag soc-trials.
- TrialAEWS0031
Shares Ifosfamide, Etoposide, Cytotoxic chemotherapy and the tag soc-trials.